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Electronic medical records (EMR) promise potential benefits for the practice of medical care. However, individual technologies such as EMR must interact with the work system as a whole — including people, technology and work practices — to enable or hinder the coordination of dynamic work demands. Based on this extended perspective, we address in this paper how support technologies (should) impact the coordination of work across multiple agents, controlling a dynamic domain with multiple, interacting processes. The technology we address is the medical record and the dynamic domain is emergency medicine as it is practiced in the U.S.

We performed 500 hours of naturalistic observations of physicians in two different hospital emergency departments in the Midwestern U.S differing in their reliance on paper or electronic medical records.

An analysis of …